Toronto board of health considers 'urgent' new measures to combat city's opioid crisis

Toronto's board of health will consider a suite of "urgent" new measures to combat what it calls an overdose crisis in the city Monday, including a plea for Ontario Premier Kathleen Wynne to immediately declare a public health emergency in response to a spike in opioid overdoses and deaths across the province.

The meeting comes on the heels of a report by the Canadian Institute for Health Information (CIHI) that found five people were hospitalized for opioid poisoning in Ontario each day between April 2016 and March 2017. The study found Toronto had the highest number of opioid-related hospitalizations in the province.

Coun. Joe Cressy, chair of the city's drug strategy implementation panel, spoke with CBC Toronto ahead of the meeting. He says that declaring the issue an emergency isn't just a matter of language.

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"If the province declares it an emergency, as a result of that, dollars can flow quickly to the people who need it and the organizations that are responding," Cressy said.

"It is an emergency, it's time we treat it as such."

Province has refused to declare emergency

Monday isn't the first time the province will be called on to declare a public health emergency in response to opioid deaths. Last month, some 700 health-care workers sent an open letter to health minister Eric Hoskins asking for the same thing.

British Columbia declared an emergency over its crisis more than a year ago, which allowed that province to collect more real-time information on overdoses to immediately identify areas at risk.

Hoskins told CBC Toronto in August that Ontario's legislation allows the province to take action on the crisis without having to declare an emergency. One day after the open letter, the provincial government announced $222 million in funding over the next two and a half years to hire more front-line harm-reduction workers, expand its naloxone supply and create new rapid access addiction clinics.

But harm reduction advocate Zoe Dodd disagrees with Hoskins.

"The province said to us when we asked for it few weeks ago that there was no end in sight, that they weren't going to call [an emergency]. But that is exactly why you call a public health emergency, because there needs to be an end in sight," said Dodd.

Besides, she says, August's funding announcement hasn't yet translated into additional funds for harm reduction workers like herself.

"We're still operating a tent in a park without any funding," she said referring to the pop-up Moss Park injection site that sprang up unsanctioned this summer.

The site is approaching its 50th day in operation and has so far stopped 31 overdoses, Dodd says. And unlike pharmacies, which receive dispensing fees and funds for training on how to use naloxone kits, the volunteers at Moss Park operate without government support.

Plan based on 5-year-old research: councillor 

The city of Toronto already has an overdose action plan, which was endorsed earlier this year and spans more than 50 measures, including opening three supervised injection sites and arming more first responders with naloxone.

But that plan is based on research that's some five years old, Cressy said, noting that more neighbourhoods have found themselves in need in life-saving resources since then.

That's why Cressy wants to see the city make naloxone available across public spaces, have city councillors trained on how to use the kits and expand the number of supervised injection across Toronto. 

Cressy says Toronto loses about one person a day to overdose. 

"To be honest, that's the equivalent of an airplane crash in the city of Toronto each year. And you better believe if we had an annual airplane crash that was having this level of death, there would be an appropriate response," he said.

Cressy will also ask Toronto's Medical Officer of Health to assess what he says are the changing dynamics and location of drug use across the city, and report back.

"What those exact neighbourhoods are and what health facilities they would go into, that's part of the next step of quick research and assessment that needs to be done," he said.

"Frankly overdose is a preventable cause of death, if we do more."